TO THE APPLICANT: Complete the top portion of the Reference Statement Form -- Employment Engagement. This handout includes sample documentation healthcare professionals can customize for patients who are seeking workplace accommodations.Please also check out the example reference letter request and the example reference letter request template which you are welcome to use. Please include your full legal name, contact information, and clear instructions on how the letter must be submitted while filling out this request. Reference statements are confidential and not subject to release to the applicant nor the Texas Public Information Act. Welcome to WritingCenter: Writing Letters of Recommendation. Who should I pick as my recommenders? Can I have professional references? How do you make a valid holographic will in Texas? Do I have to sign the handwritten will in front of a notary?